ACUTE LEUKAEMIA        A rapidly progressive cancer of the blood of sudden onset and characterised by the uncontrolled proliferation of immature blood cells which take over the bone marrow and spill into the blood stream.   ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL)   A rapidly progressing cancer of the blood affecting the type of white blood cell known as LYMPHOCYTES. ACUTE NON-LYMPHOCYTIC LEUKAEMIA  see ACUTE MYELOID LEUKAEMIA   ALLOGRAFT  see ALLOGENEIC BONE MARROW TRANSPLANT  ALOPECIA    Drugs which kill or stop the growth of BACTERIA, for example penicillin.  One form,  called antithymocyte globulin, acts specifically against T-CELLS.

 There are five forms of myelodysplastic syndrome:  Refractory anaemia  Refractory anaemia with ring sideroblasts  Refractory anaemia with excess blasts  Refractory anaemia with excess blasts in transformation  Chronic myelomonocytic leukaemia  The myelodysplastic syndromes (MDS) are a group of diseases in which the production of blood cells is severely disrupted.   Myelodysplastic syndrome arises, like leukaemia, from a single abnormal stem cell from which all the defective blood cells making up the abnormal marrow population are derived. In myelodysplasia, in contrast, the blood producing cells are all abnormal and are all derived from the same damaged stem cell.   Myelodysplasia affects all the blood cells but one or other specific problem such as anaemia, infections due to low white cell count or bleeding due to low platelet count may dominate the clinical picture.   It is important to emphasise that progression to leukaemia only occurs in a minority of cases. These are:    Refractory anaemia  Refractory anaemia with ring sideroblasts  Refractory anaemia with excess blasts  Refractory anaemia with excess blasts in transformation  Chronic myelomonocytic leukaemia The most common symptoms are those due to the low red cell count (anaemia), these include excessive breathlessness and tiredness.  The usual signs and symptoms are:    excessive tiredness on exertion  breathlessness  bleeding  easy bruising  infection  enlargement of spleen or liver Tiredness and weakness are caused by the anaemia. Initial symptoms may appear to be nothing worse than a bout of flu.   Later in the disease more severe bleeding problems and severe infections may become a problem.   Anyone who develops any of the following signs or symptoms should see a doctor:  fever which persists more than a few days  weakness or persistent tiredness  swelling in the abdomen  bleeding problems e.g. heavy periods, blood in the stool, bleeding gums when cleaning teeth  unexplained or widespread bruising  bone pain   

News and Issues This page is dedicated to Medical news as well as healthcare issues that concern all of us. Please feel free to advise me about the issues and matters that interest you the most. I make certain that common interest issues be present on this page. Issues: Are you at higher Risk of developing cancer?   What can we do about it? What you need to know about HMOs and Managed Care:

/ function statusMessageObject(p,d) { this.msg = MESSAGE this.out = " " this.pos = POSITION this.delay = DELAY this.i = 0 this.reset = clearMessage } function clearMessage() { this.pos = POSITION } var POSITION = 100 var DELAY = 30 var MESSAGE = "A site where you won't be blinded by looking at the bright side of things! " var scroll = new statusMessageObject() function scroller() { // // add spaces to beggining of message // for (scroll.i = 0; scroll.i = 0) scroll.out += scroll.msg else scroll.out = scroll.msg.substring(-scroll.pos,scroll.msg.length) window.status = scroll.out // set parameters for next run scroll.out = " " scroll.pos-- // if you are at the end of the message, // reset parameters to start again if (scroll.pos Please, take a second to save a life and call the NMDP or an area hospital for details. This page will remain as a memorial to Heath and everyone else who battles cancer. Special thanks to PC Rental in Redmond, WA for donating my computer for my hospital stay and to everyone who helped on this page. This page hosted by Get your own Free Home Page

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The Program is a combined adult and pediatric program and performs both autologous and allogeneic transplantation. Currently, the neoplastic diseases for which transplantation is performed in the Tulane program includes acute myeloblastic and lymphoblastic leukemias, chronic myelogenous leukemia, multiple myeloma, non-Hodgkin's lymphoma, Hodgkin's disease, neuroblastoma, germ cell carcinoma, ovarian cancer, and advanced breast cancer. Transplantation of bone marrow cells, and more recently stem cells collected from the blood have been used as part of the treatment for leukemias and other cancers for the past twenty years. An article in the May 19 Newsweek (page 60) discusses the possibility of using autologous stem cells that have been separated from immune cells, for transplantation in patients with autoimmune diseases. This study looks at utilizing gene therapy techniques to deliver protective genes to normal blood progenitor cells in order to give them a protective advantage in patients who are to be treated with either chemotherapy or radiation therapy. Leukemia and Myelodysplastic Syndrome 93-1 Allo.BMT for high-risk leukemias 93-3 BMT for CML in stage other than Blast Crisis or MDS 93-4 Allo.BMT for standard risk ANLL 95-2 Auto.BMT for CML 95-3 Allo.Peripheral Blood CD34 selected pregenitor transplant Hematopoietic Failure and Genetic Diseases 93-2 Allo.BMT for Sickle Cell Disease 93-7 BMT for Fanconi Anemia 95-5 BMT for Storage Disease IBMTR: BMT for Storage Disease Lymphoma and Myeloma 95-1 Auto.BMT for M.M. 96-1 Hodkin's disease Solid Tumors 93-6 Auto.BMT for Breast Cancer 94-1 Auto.BMT for Breast Cancer 94-2 Auto.BMT for Neuroblastoma 96-2 Auto.BMT for Germ Cell Tumors

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Visit the Children's Art Gallery This week's artwork was donated by Jason a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia. 847-831-1913 (phone) 847-831-1943 (Fax) help@bmtnews.org OncoLink is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through OncoLink should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. For further information, consult the Editors at: editors@oncolink.upenn.edu

Acute Myeloid Leukemia-Type Chemotherapy for Newly Diagnosed Patients Without Antecedent Cytopenias Having Myelodysplastic Syndrome as Defined by French-American-British Criteria: A Cancer and Leukemia Group B Study By Steven H. Bernstein, Virginia L. Brunetto, Frederick R. Davey, Doris Wurster-Hill, Robert J. Mayer, Richard M. Stone, Charles A. Schiffer, and Clara D. Bloomfield Purpose: To determine the treatment outcome of standard acute myeloid leukemia (AML)-type chemotherapy in a subset of patients with newly diagnosed myelodysplastic syndromes (MDS) compared with that of patients with de novo AML as defined using French-American-British (FAB) criteria. In addition, to determine the pretreatment variables having prognostic significance for treatment outcome in patients with MDS. Patients and Methods: Nine hundred seven newly diagnosed patients with no history of cytopenias having a local institutional de novo AML successfully karyotyped and treated on Cancer and Leukemia Group B (CALGB) protocols for AML from 1984 to 1992. Thirty-three of the 907 patients were reclassified as having MDS on central pathology review using FAB criteria and form the basis of this analysis. Results: The treatment outcomes for patients with MDS and AML were similar; the complete remission (CR) rate was 79% and 68%, respectively (P = . Conclusion: In patients with no known history of cytopenias who are treated intensively at diagnosis, the FAB distinctions between MDS (refractory anemia with excess blasts and refractory anemia with excess blasts in transformation) and AML appear to have little therapeutic relevance.

Myelodysplastic Syndrome (MDS) This illness originates in Myeloid cells of the bone marrow. Average age of patients at the time of diagnosis is 60-70 years. This disease does not respond to conventional treatment and the only method that may cure some patients is bone marrow transplant. Refractory anemia Refractory anemia with ring sideroblasts Refractory anemia with increased blast cells Refractory anemia in transformation into acute Leukemia Chronic Myelomonocytic Leukemia Entities in the lower end of the list are more difficult illnesses and have a worse prognosis with a shorter survival. Patients with Refractory anemia have a better prognosis and the illness may stay dormant for years, however, it will eventually progress into the more serious stages of this illness and even into a Leukemia. Those patients who are younger than 55 years of age should be considered for a bone marrow transplant which can cure up to one third of patients.

Myelodysplastic Syndrome (MDS) This illness originates in Myeloid cells of the bone marrow. Average age of patients at the time of diagnosis is 60-70 years. This disease does not respond to conventional treatment and the only method that may cure some patients is bone marrow transplant. Refractory anemia Refractory anemia with ring sideroblasts Refractory anemia with increased blast cells Refractory anemia in transformation into acute Leukemia Chronic Myelomonocytic Leukemia Entities in the lower end of the list are more difficult illnesses and have a worse prognosis with a shorter survival. Patients with Refractory anemia have a better prognosis and the illness may stay dormant for years, however, it will eventually progress into the more serious stages of this illness and even into a Leukemia. Those patients who are younger than 55 years of age should be considered for a bone marrow transplant which can cure up to one third of patients.

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Evidence of this comes from the large percentage of MDS cases and some acute myeloid leukemia (AML) cases without cytogenetic alterations (approximately 50% and 30%, respectively). Male:female ratio: 2:1 Age at onset:6 months to 19 yrs (median = 7 yrs) Clinical complications:Infection and bleeding Background:Usually no exposure to genotoxins, but multiple sibling cases indicate possible predisposition Presenting hematology:Anemia, decreased platelets, normal or elevated white blood cell count (especially monocytes), marrow hyperplasia Myelodysplastic stage:Duration up to 12 yrs (median = 2.2 yrs); may be categorized as idiopathic myelofibrosis Cytogenetics:Percentage of monosomic cells in marrow increases with progression; additional alterations often arise with transformation Subtype of acute leukemia at progression: frequently transforms to AML M1, M2, and M4 Most MDS-associated aberrations are deletions or trisomies. At present, it is not known what causes transformation in the few patients who present with a deletion and no other cytogenetic change but progress to AML (Fig 1). The following observations are generally accepted23,24: (1) Survival is longer for patients without a detectable abnormal clone, (2) the most consistent anomaly is a 14q+ alteration with t(11;14)(q13;q32) predominating, (3) the often complex abnormal clones are typified by loss of tumor suppressor genes and nonrandom trisomy but not trisomy 12, and (4) prognosis worsens with increasing proportions of clonally abnormal cells detected. This technology will probably be better applied to the analysis of MDS rather than acute leukemia since balanced translocations (the major oncogenic mechanism in acute leukemia) are not easily detected by FISH. Deletions and trisomy tend to typify MDS, while balanced translocations are found in AML or in cases with brief MDS phases preceding AML.

MY name is Diane Martinez, I am from Colorado Springs, Colorado. I am wife of Daniel Martinez for 13 years, and we have 2 beautiful children Danielle 9yrs, and Nicholas 6yrs. My reason for putting this page together is simple. Doctors find it difficult to find a match because of my Hispanic background. Hispanics only make up 6% of the Bone Marrow Registry, which is very small, making my chances very small. Below are links to several different areas to look at if you want information on Bone Marrow Transplants, becoming a donor, or to learn more about my disease.

There are treatments for all patients with MDS. Individual treatment plans are chosen based on the type of myelodysplastic syndrome a patient has, the patient's age and general health. Generally, chemotherapy is useful for such conditions as RAEB, RAEB-t, and CMML. Chemotherapy may not begin until the disease shows signs of becoming aggressive. At the University of Texas, the new drug Topotecan has been shown to produce hematologic remissions in 33 to 50 percent of patients with CMML and MDS. Aggressive multi-agent regimens achieve complete remissions that range from 13 percent to greater than 50 percent of MDS patients. Growth factors normally control the production of the blood cells and are being tested clinically to encourage patients' bone marrow to produce healthy cells and platelets. Growth factors could also be useful before, during or after chemotherapy to protect healthy blood cells in the marrow from the effects of cell-killing chemotherapy. The availability of this new agent provides a potentially encouraging new therapy that might benefit patients with a variety of blood disorders, including MDS. Therapies that use vitamin A (retinoic acid), vitamin D and other biological agents to correct the failure in production of mature blood cells characteristic of MDS are also being explored.

An accurate diagnosis can only be made by a full evaluation of the blood and bone marrow. If symptoms are present, a doctor may perform a blood test to count each kind of cell in the blood and see if the marrow is working properly. This test is called a complete blood count (CBC). If the blood test results are not normal, a bone marrow sample may be needed to better diagnose the disorder. When a sample is taken from the hip, patients usually lie on their side or stomach.The skin where the sample will be taken is first cleansed, then numbed with a medication simllar to Novocaine (like the dentist uses). Information from the cytogenetic test helps to confirm the diagnosis of MDS and enables the doctor to develop a more specific treatment plan for the patient.

If you or a loved one have a myeloproliferative disorder YOU ARE NOT ALONE! INFORMATION And SUPPORT Are Just a Click Away Letter From The Director MPD VOICE Newsletter MPD-NET an Online Support Group Inside MPD Biographies Medical Information Sources Other Support Groups of Interest If you have any suggestions, comments or ideas on how to make this site more useful to you, please let us know!

The AAFA offers the following free publications about aplastic anemia and myelodysplastic syndrome in English, Spanish, French and Japanese: Aplastic Anemia: Answer Book Myelodysplastic Syndrome: Answer Book Aplastic Anemia: Introduction for the General Physician Families Coping With Hospital Life Communicating to the Medical Care Team A Book for You - Specifically for Children AAFA Quarterly Newsletters In addition to these publications, the AAFA also offers fact sheets on: The Blood System; Aplastic Anemia and Myelodysplasia Explained; Drug Therapy; and Bone Marrow Transplantation. The AAFA Network of Volunteers are patients and families who talk with others about the disease. AAFA provides over 10,000 informational brochures sent out free of charge each year to patients, family members and health care professionals all over the world. AAFA has dozens of nationwide chapters and support groups providing local assistance and resources, medical information, bone marrow donor drives, and fundraising for AAFA research. AAFA publishes a quarterly newsletter containing stories of how others have coped with disease, information on medical treatments and research, AAFA activities, questions and answers from our readers, and a link to others who are battling aplastic anemia and myelodysplasia.

The OHAKC/Saint Luke's BMT Program is an affiliate of the Greater Kansas City Blood and Marrow Transplant group (KCBMT) along with Children's Mercy Hospital, the Community Blood Center of Greater Kansas City, and the Midwest Organ Bank. The OHAKC/Saint Luke's BMT Program performs autologous or related allogeneic transplants for the following diseases: Autologous BMT Allogeneic BMT Hodgkin's Disease X X Non-Hodgkin's Lymphoma X X Multiple Myeloma X X Acute Myelogenous Leukemia X X Acute Lymphocytic Leukemia X X Chronic Myelogenous Leukemia X X Chonic Lymphocytic Leukemia X X Myelodysplastic Syndrome X Aplastic Anemia X Breast Cancer X Ovarian Cancer X Testicular Cancer X Outcomes: To ensure quality care, the OHAKC/Saint Luke's BMT Program continually monitors outcomes focusing on efficacy, morbidity, pharmacoeconomics, and quality of life. Outpatient Management of BMT Patients: Recent advances including rapid engraftment with peripheral blood stem cell collection and enhanced supportive care strategies have facilitated a shift from total inpatient management during BMT to more outpatient care of these patients. Potential advantages of outpatient care include: Improved patient satisfaction and quality of life Minimization of expensive resources including hospitalization Participation of patient and caregiver in delivery of care Earlier overall recovery and return to society Outpatient management is utilized only in appropriate patients based on intensive psychosocial and caregiver criteria and assessment along with routine BMT eligibility criteria. Other multi-disciplinary team members include: Elaine Stenstrup, RN, MSN, OCN Clinical Nurse Specialist Carol Nelson, RN Oncology Service Line Leader Jackie Coon, RN, OCN Nurse Clinician Sharon Howard, RN, OCN Nurse Clinician Kent Wurm, PharmD Oncology Clinical Pharmacist Melinda Pine, RD Nutritionist Deborah Garnett, PhD, RN Psychology Consultant Cindy Dale, MSW Oncology Social Worker Debbie DeLong, RN Saint Luke's Home Health Care Terry Sommers Community Blood Center Bernie Graves Community Blood Center Mary Beth Skelton OHAKC Executive Director Jamilla Murga OHAKC Insurance Specialist Kathy Cord Data Manager By offering a comprehensive program in the Kansas City area, BMT is incorporated into the continuium of oncology care in an efficient and accessible manner. For example, after the patient is referred, an autologous peripheral blood stem cell transplant performed in an outpatient setting typically follows this outlined schedule: Week 1 BMT consult with multidisciplinary team Discuss appropriateness and timing of BMT with refferring MD Weeks 2-4 Insurance evaluation Patient & family education including caregiver class, pyschosocial evaluation, and home assessment Pre-BMT testing Week 5 Review of pre-BMT evaluation Patient consent visit Weeks 6-7 Mobilization regimen (CSFs +/- chemotherapy) Stem cell collection via 1-3 apherses Weeks 8-9 High dose chemotherapy regimens (3-5 days) Stem Cell Infusion Weeks 10-11 Pre-engraftment phase including daily patient assessments for supportive care to manage infection, gastrointestinal complications, transfusion needs, and other toxicities Week 12 Post engraftment phase including visits as needed Week 13 Discharge patient to referring physician following communication of posttransplant needs Transplants performed in an inpatient setting follow a similar schedule initially, then typically require four to five weeks of hospitalization.

To subscribe or unsubscribe: FIRST, read the following choices and short descriptions where provided, and click the "subscribe" (or "unsubscribe") buttons as necessary, for any or all of them. SUBSCRIBE to AA-MDS-TALK UNSUBSCRIBE from AA-MDS-TALK ADEN-CYST ADEN-CYST is an unmoderated discussion list for parents, sibblings, friends, researchers, and physicians, to discuss clinical and nonclinical issues and advances pertaining to Adenoid Cystic Carcinomas. SUBSCRIBE to CARCINOID UNSUBSCRIBE from CARCINOID CAREGIVERS CAREGIVERS is an unmoderated discussion list for parents, siblings or friends of cancer patients. SUBSCRIBE to COLON CANCER UNSUBSCRIBE from COLON CANCER CSHCN-L - Children with Special Health Care Needs SUBSCRIBE to CSHCN-L UNSUBSCRIBE from CSHCN-L CTCL-MF: Cutaneous T-Cell Lymphoma- Mycosis Fungoides Information/Support List This list is for patients, family, friends, researchers, and physicians to discuss information pertaining to Cutaneous T-Cell Lymphoma/Mycosis Fungoides. SUBSCRIBE to CTCL-MF UNSUBSCRIBE from CTCL-MF DESMOID: Desmoid Tumor Online Support Group DESMOID is an unmoderated discussion list for parents, siblings, friends, researchers, and physicians, to discuss clinical and nonclinical issues and advances pertaining to Desmoid Tumors (Aggressive Fibromatosis). SUBSCRIBE to EC-GROUP UNSUBSCRIBE from EC-GROUP E-SARCOMA: Ewing Sarcoma Online Support Group E-SARCOMA is an unmoderated discussion list for patients, parents, friends, researchers, and physicians, to discuss clinical and nonclinical issues and advances pertaining to Ewing Sarcomas.

Our Price: $117.25Availability: This title usually ships within 4-6 weeks. We will notify you within 2-3 weeks if we have trouble obtaining this title. Publication date: June 1991 1-ClickSM ordering Have you read this book? Write an online review and share your thoughts with other readers. I read this book, and I want to review it.

Hyper-CVXD (Liposomal Daunorubicin) (DM96-095) PEG Asparaginase + vincristine + methotrexate +prednisone (MOAP) 2CDA + Ara-C + Cytoxan (DMP95-210) Idarubicin+ifosfamide+vincristine+prednisone Compound 506 (DM96-312) in T-Cell See article. Acute Promyelocytic leukemia: cytogenetic feature: t(15;17): Liposomal ATRA (DM97-153) Acute Myelocytic Leukemia and RAEB-T or RAEB by FAB criteria: Good prognosis: Good Cytogenetics: Idarubicin + Ara-C + G-CSF + ATRA (DMP97-168) Other Cytogenetics: Cytoxan + Ara-C + Topotecan + G-CSF + ATRA (DMP97-169) Poor prognosis: Fludarabine + Ara-C + Idarubicin + G-CSF + ATRA (DM95-063) Interferon alpha plus low dose ara-C (DM95-172) in CR Allo PBSCT "Transplant lite" (age <70) (DM95-194) Autoimmune Phenomena: Cyclosporin-A (DMP96-297) Hairy Cell Leukemia: 2-CDA T-Cell Lymphoproliferative Disease: Compound 506, Compound 506 + Fludarabine Richter's Transformation: FACP-GM or Hyper-CVXD Patients who achieve remission will be referred for allogeneic BMT or autologous BMT if available. Allogeneic: Any patient with an available match and age < 55 years in chronic phase > 1 year from diagnosis who has not had a cytogenetic response to alpha interferon after 12 months in early chronic phase if unable to tolerate IFN-A presenting with accelerated disease or blastic phase Related matched: IV Busulfan + Cyclophosphamide (DM96-001). Autologous: CTX+VPI6+TBI and Autologous BMT patients with accelerated, blastic or second chronic phase who have an autologous bone marrow stored in chronic phase.

Number of blood cells in the blood stream depends on three factors: -- Rate of production -- Rate of release -- Length of survival There are two types of marrow: -- Yellow marrow (Inactive) composed primarily of fat. -- Red marrow (active in hematopoiesis) Distribution of active marrow can be determined by administering radioactive iron: LOCATION% of TOTAL MARROW Pelvis40 Vertebrae28 Cranium-mandible13 Ribs8 Sternum2 Ends of long bones8 Total marrow space in the adult is about 4 liters. Total marrow space in the child is about 1.6 liters. Megakaryocytes: Mature megakaryocytes line the sinusoids and discharge platelets directly into the blood stream. If we consider the marrow to be the blood cell "factory," the "retail store" is the peripheral blood.

"Allogeneic bone marrow transplantation for 93 patients with myelodysplastic syndrome. de Sauvage FJ, Hass PE, Spencer SD et al. "A phase I/II study of sequential lnterleukin-3 and granulocyte-macrophage colony stimulating factor in myelodysplastic syndromes.

THE MERCK MANUAL   The Sixteenth Edition of The Merck Manual was published in 1992, and many parts of this version are now out of date with current medical practices. MYELODYSPLASTIC SYNDROME (MDS) (Preleukemia; Refractory Anemias; Ph-Chromosome -Negative Chronic Myelocytic Leukemia; Chronic Myelomonocytic Leukemia; Agnogenic Myeloid Metaplasia) A clonal proliferative disorder in which a normal or hypercellular bone marrow is associated with an ineffective and dysmyelopoiesis. MDS is a recent designation for a group of syndromes (listed above as synonyms) commonly seen over age 50. Its incidence is unknown, but there is the clinical impression that it is increasing, probably in part owing to the increasing proportion of elderly in the population and an increase in treatment-associated leukemias. All rights reserved.

anemia A condition caused by a decrease in the number of red blood cells. blood cells Made in the bone marrow, consist of red blood cells, white blood cells and platelets. It carries oxygen to body cells and carbon dioxide away from the cells. red blood cells Produced by the bone marrow, red blood cells circulate in the blood and carry oxygen to all parts of the body. stem cells Refers to cells that have the ability to mature into any of the different blood cell types. white blood cells (WBCs) Cells produced by the bone marrow and lymph nodes.

New on Myelodysplastic Syndrome (MDS) Amifostine has shown some efficacy in improving blood cell production in patients with MDS. This discovery has lead into more investigations and design of a few clinical trials to enroll a number of patients with MDS..

Many patients with MDS will go to see their doctor because they feel symptoms of anemia. Anemia means there are too few red blood cells to carry oxygen to the body, causing patients to feel tired (fatigue) and short of breath. For many patients, there may be too few white cells to fight infections. Patients may have infections that do not get better after taking antibiotics. A shortage of platelets is commonly found in MDS patients. Patients should report these symptoms to their health care provider so that the status of the MDS can be determined, and treatment started to relieve many of these symptoms.

The bone marrow makes red blood cells (which carry oxygen and other materials to all tissues of the body), white blood cells (which fight infection), and platelets (which make your blood clot). Myelodysplastic syndromes are grouped together based on how the bone marrow cells and blood cells look under a microscope. There are five types of myelodysplastic syndromes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia. Secondary myelodysplastic syndromes develop following treatment with radiation therapy or chemotherapy for other diseases. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and affects cells throughout the body. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body.

] Click on selected entry to go to relevant MeSH page [ A | Lacrimal Duct Obstruction Lactation Disorders Lactose Intolerance Landau-Kleffner Syndrome Larsen Syndrome (not a MeSH term) Larva Migrans Laryngeal Neoplasms Laryngomalacia Laurence-Moon-Biedl Syndrome Legg-Perthes Disease Legionellosis Leigh Disease Leiomyoma Leiomyosarcoma Leishmaniasis Lennox-Gastaut Syndrome ( --> Epilepsy) Leprosy Leptospirosis Leukemia Leukodystrophy (not a MeSH term) Lissencephaly Listeria Infections Liver Cirrhosis Liver Diseases Loiasis Long QT Syndrome Lou Gehrig's Disease ( --> Amyotrophic Lateral Sclerosis ) Ludwig's Angina Lupus Erythematosus, Systemic Lupus (Vulgaris) Lyme Disease Lymphangioma Lymphangiomyomatosis Lymphedema Lymphoma, Non-Hodgkin's Lymphoma

The bone marrow makes red blood cells (which carry oxygen and other materials to all tissues of the body), white blood cells (which fight infection), and platelets (which make your blood clot). Myelodysplastic syndromes are grouped together based on how the bone marrow cells and blood cells look under a microscope. There are five types of myelodysplastic syndromes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia. Secondary myelodysplastic syndromes develop following treatment with radiation therapy or chemotherapy for other diseases. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and affects cells throughout the body. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body.

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The bone marrow makes red blood cells (which carry oxygen and other materials to all tissues of the body), white blood cells (which fight infection), and platelets (which make your blood clot). Myelodysplastic syndromes are grouped together based on how the bone marrow cells and blood cells look under a microscope. There are five types of myelodysplastic syndromes: refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and chronic myelomonocytic leukemia. Secondary myelodysplastic syndromes develop following treatment with radiation therapy or chemotherapy for other diseases. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and affects cells throughout the body. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body.

The major objective of this group-wide study is to determine the efficacy of both an intensive induction course and an intensive consolidation course (conventional aggressive therapy or bone marrow transplantation) for children with acute non-lymphocytic leukemia (ANLL). Specifically, the study objectives are: To compare the efficacy of an intensive five drug induction therapy given over four days, with an "obligatory" further intensification of induction therapy after six days of rest using the same agents, to the use of the same five-drug/four day induction cycle repeated in a more standard fashion 14 days from the first cycle or later, depending on marrow status. To compare the induction failure rate, morbidity and death rate of patients receiving the aggressive induction timing with that in patients receiving the standard timing regimen. As of 2/11/94, it has been determined that event free survival for patients treated on the standard timing arm is statistically worse than that of patients treated on the intensive timing arm. To compare the toxicity and efficacy of an aggressive marrow ablative therapy followed by bone marrow transplantation rescue as the sole "intensification" therapy for patients achieving remission in this protocol with an aggressive conventional therapy given over several months and not requiring bone marrow rescue. Children with Down Syndrome who have cell subtypes of acute non-lymphocytic leukemia (ANLL), excluding acute promyelocytic leukemia (APO, FAB M3 ), or myelodysplastic syndrome (preleukemia) previously untreated for those conditions, i.e., no prior chemotherapy or radiation therapy for ANLL or MDS; Wright or Giemsa, and chloracetate esterase (or non-specific esterase stain) with and without fluoride inhibition, PAS, Peroxidase and Sudan Black stains must be performed on the initial diagnostic bone marrow along with cytogenetics and cell markers.

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Follow-up appointments with your doctor on a regular basis are very important to evaluate your response to treatment and disease progression. Your doctor will want to discuss any symptoms you are having and do periodic blood counts. Prognosis depends upon the type of myelodysplastic syndrome you have, your age, and the treatment you receive. Some patients need minimal supportive care and observation while other patients may require more intensive treatment. Patients have many important questions to ask about their disease, and their doctor is the best person to provide answers. If you have questions or concerns about your treatment and prognosis do not hesitate to discuss these with your doctor.

Visit the Children's Art Gallery This week's artwork was donated by Jason a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia. The Hypermedia PDQ project is supported, in part, by grants from the National Cancer Institute and the National Action Plan on Breast Cancer. CancerNet also contains PDQ information for patients; see the CancerNet Contents List for PDQ for more information. General information Cellular classification Stage Information Treatment option overview De novo myelodysplastic syndrome Secondary myelodysplastic syndrome Previously treated myelodysplastic syndrome The Hypermedia PDQ project is supported, in part, by grants from the National Cancer Institute and the National Action Plan on Breast Cancer. The information provided through OncoLink should not be used for diagnosing or treating a health problem or a disease.

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Visit the Children's Art Gallery This week's artwork was donated by Jason a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia. The Hypermedia PDQ project is supported, in part, by grants from the National Cancer Institute and the National Action Plan on Breast Cancer. CancerNet also contains PDQ information for patients; see the CancerNet Contents List for PDQ for more information. General information Cellular classification Stage Information Treatment option overview De novo myelodysplastic syndrome Secondary myelodysplastic syndrome Previously treated myelodysplastic syndrome The Hypermedia PDQ project is supported, in part, by grants from the National Cancer Institute and the National Action Plan on Breast Cancer. The information provided through OncoLink should not be used for diagnosing or treating a health problem or a disease.

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In the past two decades, bone marrow transplantation (BMT) has become an effective, life-saving procedure for a number of malignant and non-malignant diseases.

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Click the image to see a more detailed version. Case 1 Bone marrow smear, May-Giemsa stain, x200 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Clot Section, Hematoxylin and eosin stain, x200 Clot Section, Hematoxylin and eosin stain, x400 Bone marrow smear, May-Giemsa stain, x1000 Case1 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Bone Marrow biopsy, Hematoxylin and eosin stain, x200

Click the image to see a more detailed version. Case 1 Bone marrow smear, May-Giemsa stain, x200 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Clot Section, Hematoxylin and eosin stain, x200 Clot Section, Hematoxylin and eosin stain, x400 Bone marrow smear, May-Giemsa stain, x1000 Case1 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Bone Marrow biopsy, Hematoxylin and eosin stain, x200

The FHCRC has an active treatment and research program for marrow and blood stem cell transplantation for patients with hematological diseases and selected patients with chemotherapy sensitive solid tumors. Patients with blast phase of CML receive TBI and CY followed by allogeneic PBSC. Unrelated, mismatched related or autologous transplant protocols are also available for patients with CML who do not have an HLA matched related donor Malignant Lymphoma (ML) Patients with HLA-matched family member donors receive allotransplants, but the majority of patients with malignant lymphoma receive autologous PBSC transplants. Patients less than 56 years old with HLA-identical unrelated donors and no evidence for excess blasts are prepared for transplant with CY and BU with individual adjustment of BU dose based on blood levels. High risk first remission patients and those beyond first remission: Patients with matched sibling donors are eligible for the TBI plus CY regimen and IL-2 administered post-transplant. Chronic Myeloid Leukemia (CML) Children with adult type CML in chronic phase: receive a preparative regimen of CY and 12.0 Gy TBI and marrow transplant from HLA matched siblings or CY and 14.40 Gy TBI and marrow from partially matched family members or unrelated donors. Recurrent Wilms' Tumor Patients with recurrent Wilms' tumor who achieve a second remission are treated with a thiotepa, etoposide, CY preparative regimen followed by autologous marrow or PBSC. Thalassemia Patients with life-threatening thalassemia are eligible for transplantation with BU, CY and ATG.

Click the image to see a more detailed version. Case 1 Bone marrow smear, May-Giemsa stain, x200 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Clot Section, Hematoxylin and eosin stain, x200 Clot Section, Hematoxylin and eosin stain, x400 Bone marrow smear, May-Giemsa stain, x1000 Case1 Bone marrow smear, May-Giemsa stain, x1000 Case 2 Bone Marrow biopsy, Hematoxylin and eosin stain, x200

MDS may be diagnosed at an early stage of its development, sometimes unexpectedly after a routine blood test. Patients can live for years before there are any symptoms or any need for treatment. Such patients can look forward to many years of normal life, although this is impossible to predict with certainty. If a diagnosis is made in a later stage in the development of the disease, then treatment usually needs to start immediately. The quality of life for many patients has been enhanced thanks to recent advances made in understanding this disease. As the focus of investigations into this disease increases, so does the hope for better survival and quality of life for people with MDS. Back to the top Previous |

The Leukemia Society of America would like to acknowledge staff at the University of Iowa Hospitals and Clinics who contributed and reviewed much of the material contained in this booklet. The Society thanks the following professionals who served as contributors: Linda Abbott, RN, BSN, OCN, C. Patrick Burns, M.D., Chouang Baccam, BSN, Barbara Dietz, BSN, OCN, Heather Dillon, RN, BSN, Joan Felkner, MA, Raymond Hohl, M.D., Ph.D., Charles Riggs, Jr. Printing of this publication has been made possible by an educational grant provided by Pharmacia Inc.

 Introduction for the General Physician Aplastic anemia is a hematologic disorder characterized by a decrease in the cellular elements of the peripheral blood. Aplastic anemia develops before age 30-40 in patients who are predisposed due to a congenital chromosomal abnormality such as Fanconi's anemia or dyskeratosis congenita. Acquired aplastic anemia may be caused by toxic chemicals, radiation, or by idiosyncratic reactions to medications or infections.  Making the Diagnosis Patients with aplastic anemia generally present with symptoms of bleeding or bruising due to the thrombocytopenia (low platelets), tiredness or pallor due to the anemia (low hemoglobin), or infection due to the neutropenia (low white blood cell count). Aplastic anemia is usually categorized as severe if, in addition to a hypocellular bone marrow for age, two of the three following criteria are present: a platelet count of less than 20,000/mm3, a corrected reticulocyte count of less than 1%, and a granulocyte or absolute neutrophil count [ANC = total white count x (segs + bands)] of less than 500/mm3. Patients With pancytopenia, but not severe enough to meet the above criteria, have mild or moderate aplastic anemia. Very severe aplastic anemia exists if the ANC or granulocyte count is less than 200/mm3. When aplastic anemia is diagnosed, all drugs or medications the patient is on should be stopped if possible.

Choose one of the following options to see the information directly: OVERVIEW OF PDQ DESCRIPTION STAGE EXPLANATION TREATMENT OPTION OVERVIEW DE NOVO MYELODYSPLASTIC SYNDROME SECONDARY MYELODYSPLASTIC SYNDROME PREVIOUSLY TREATED MYELODYSPLASTIC SYNDROME TO LEARN MORE PDQ is a computer system that gives up-to-date information on cancer treatment. The treatment information in this summary is based on information in the PDQ treatment summary for health professionals on this cancer. If clinical trials show that the new treatment is better than the treatment currently being used, the new treatment may become the "standard" treatment. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body. The following general booklets on questions related to cancer may be helpful: Chemotherapy and You: A Guide to Self-Help During Treatment Radiation Therapy and You: A Guide to Self-Help During Treatment Research Report: Bone Marrow Transplantation Eating Hints for Cancer Patients What Are Clinical Trials All About?

The myelodysplastic syndromes transform to acute myeloid leukemia in about 30% of patients after various intervals from diagnosis, and at variable rates (refer to the cellular classification section for more information). The myelodysplastic syndromes occur predominantly in older patients (usually over 60 years of age), although patients as young as 2 years have been reported. Refractory anemia with ringed sideroblasts (RAS) The blood and marrow are identical to those in patients with RA, except that at least 15% of marrow red cell precursors are ringed sideroblasts. Anemia should be treated with red cell transfusions regularly, and younger patients should be considered for iron chelation therapy with subcutaneously administered desferrioxamine and vitamin C.[1] Desferrioxamine may improve granulocyte and platelet counts in some patients, and it may reduce red cell transfusion requirements. [7] Although most anemic patients with myelodysplastic syndromes have markedly elevated levels of erythropoietin, occasional patients have unexpectedly lower values. [16,17] Outcome tends to be better in younger patients with fewer bone marrow blasts, but long-term benefit has been noted in all FAB types, and in patients with marrow fibrosis, a variety of karyotypic findings, and different preparative regimens.

function winopen(TOC){ //function TOCWin(msg) { //set up window options stats='toolbar=no,location=no,directories=no,status=no,menubar=no,' stats += 'scrollbars=yes,resizable=yes,width=250,height=600' //open the window MsgBox = window.open ("/nci/cancernet/toc/202495_toc.html","msgWindow",stats) //set window back color, text color, show msg, and OK button. PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. To learn more about myelodysplastic syndromes, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237)TTY at 1-800-332-8615 By dialing this toll-free number, trained information specialists can answer your questions. The following general booklets on questions related to cancer may be helpful: Chemotherapy and You: A Guide to Self-Help During Treatment Radiation Therapy and You: A Guide to Self-Help During Treatment Research Report: Bone Marrow Transplantation Eating Hints for Cancer Patients What Are Clinical Trials All About?

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PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ. To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body. The following general booklets on questions related to cancer may be helpful: Chemotherapy and You: A Guide to Self-Help During Treatment Radiation Therapy and You: A Guide to Self-Help During Treatment Research Report: Bone Marrow Transplantation Eating Hints for Cancer Patients What Are Clinical Trials All About?

Clonal stem cell disorder with heterogeneous clinical and hematologic presentations. Myelodysplastic syndromes are characterized by dysplastic changes present in the myeloid cells, with or without an increase in blasts. Myelodysplastic syndromes are classified in the FAB system by several different features, which include quantitation of blasts in peripheral blood and bone marrow. Patients with myelodysplastic syndrome typically present with pancytopenia, usually do not have organomegaly, and chromosomal abnormalities are found in up to 50% of cases. The treatment for MDS is generally supportive but may include chemotherapy and bone marrow transplant in some cases. Those cases which progress to acute leukemia have a worse prognosis that de novo acute leukemia.

"Confronting Cancer Through Art" is an exhibition by people whose lives have been touched by cancer. This week we are featuring artwork by: Visit the Children's Art Gallery This week's artwork was donated by Jason a pediatric cancer patient who received treatment for cancer at The Children's Hospital of Philadelphia. BMTs for Myelodysplastic Syndrome Types of MDS BMT Preparing for BMT Infection Timing of BMT Volunteer fireman confronts MDS Seattle woman regains her independence Michigan BMT survivor is a living miracle Patient beats MDS and insurance company our Turn News bits Special thanks Contact BMT Newsletter Myelodysplasia or myelodysplastic syndrome (MDS) is a term used to describe five diseases of the bone marrow

Choose one of the following options to see the information directly: OVERVIEW OF PDQ DESCRIPTION STAGE EXPLANATION TREATMENT OPTION OVERVIEW DE NOVO MYELODYSPLASTIC SYNDROME SECONDARY MYELODYSPLASTIC SYNDROME PREVIOUSLY TREATED MYELODYSPLASTIC SYNDROME TO LEARN MORE PDQ is a computer system that gives up-to-date information on cancer treatment. The treatment information in this summary is based on information in the PDQ treatment summary for health professionals on this cancer. If clinical trials show that the new treatment is better than the treatment currently being used, the new treatment may become the "standard" treatment. Bone marrow transplantation is a newer type of treatment that uses high doses of chemotherapy and/or radiation therapy (high doses of x-rays or other high-energy rays) to destroy all of the bone marrow in the body, then transplants healthy bone marrow back into the body. The following general booklets on questions related to cancer may be helpful: Chemotherapy and You: A Guide to Self-Help During Treatment Radiation Therapy and You: A Guide to Self-Help During Treatment Research Report: Bone Marrow Transplantation Eating Hints for Cancer Patients What Are Clinical Trials All About?

Important: This information is intended for use by doctors and other health care professionals. If you are a cancer patient, your doctor can explain how it applies to you, or you can call the Cancer Information Service at 1-800-422-6237.

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The myelodysplastic syndromes are a group of disorders characterized by one or more peripheral blood cytopenias secondary to bone marrow dysfunction. The myelodysplastic syndromes transform to acute myeloid leukemia in about 30% of patients after various intervals from diagnosis, and at variable rates (refer to the cellular classification section for more information). The myelodysplastic syndromes occur predominantly in older patients (usually over 60 years of age), although patients as young as 2 years have been reported. Anemia should be treated with red cell transfusions regularly, and younger patients should be considered for iron chelation therapy with subcutaneously administered desferrioxamine and vitamin C.[1] Desferrioxamine may improve granulocyte and platelet counts in some patients, and it may reduce red cell transfusion requirements. [7] Although most anemic patients with myelodysplastic syndromes have markedly elevated levels of erythropoietin, occasional patients have unexpectedly lower values. [17,18] Outcome tends to be better in younger patients with fewer bone marrow blasts, but long-term benefit has been noted in all FAB types, and in patients with marrow fibrosis, a variety of karyotypic findings, and different preparative regimens.

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